Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Avoiding preventable emergency presentations: outcomes of the Rapid Access Clinic Expansion (RACE) service at a tertiary regional cancer centre  (146565)

Martina O'Neill 1 , Kacy J Ringshaw 1 , Connor Stewart 2 , Cassandra J Mazza 1 3 , Katrina West 1 , Ebony V Hetherington 1 , Marius Pezard-Snell 1 , Rebecca Crust 1 , Georgia Parker 1 , Bahar Peker 1 , Jessica Garrett 1 , Michael J Allen 2 4 , Cassie Turner 2 3 4 5 , Bryan A Chan 1 2 4 5 6
  1. Cancer Care Services, Sunshine Coast University Hospital and Health Service, Birtinya, QLD, Australia
  2. School of Medicine and Dentistry, Griffith University, Sunshine Coast, Qld, Australia
  3. Frazer Institute, Faculty of Health Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia
  4. Department of Medical Oncology, Sunshine Coast University Hospital, Birtinya, Qld, Australia
  5. School of Medicine, The University of Queensland, Brisbane, Qld, Australia
  6. Faculty of Health Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia

Introduction 

Increasing complexity of systemic anti-cancer therapy has driven demand for responsive oncology urgent care services. Ambulatory models may provide a safe and sustainable alternative to traditional emergency department (ED) assessment pathways. 

Aim 

To evaluate patient acuity, management pathways and clinical outcomes from the Rapid Access Clinic Expansion (RACE) ambulatory urgent care service, including its impact on ED avoidance. 

Methods 

A retrospective quality-improvement evaluation of all patient encounters managed through RACE between January 2023 and April 2026 was undertaken. Patient demographics, cancer type, triage acuity, management pathways and outcomes were extracted from electronic medical records and analysed using descriptive statistics. Presentations were triaged according to the United Kingdom Oncology Nursing Society (UKONS) criteria: Green indicated mild symptoms suitable for self-management with advice; Amber indicated moderate symptoms requiring clinical assessment and intervention; and Red indicated severe or potentially life-threatening symptoms requiring urgent assessment and management. 

Results 

RACE managed 1,587 patient encounters during the study period, avoiding ED presentation in 1,324 (83.4%) cases. Management pathways included telephone intervention (n=909), outpatient review (n=162), direct ward admission (n=135), ED assessment (n=263) and other pathways (n=118). UKONS triage categories were Green (n=638), Amber (n=378), and Red (n=539), with 32 encounters classified as inappropriate for RACE triage. Notably, 62% of red presentations were managed outside ED. Median age was 67 years, 56% were female and the most frequent tumour streams were breast, gastrointestinal and lung malignancies. Common presentations included: pain (n=377), diarrhoea (n=214), fatigue (n=213), infection-related concerns (n=160), and functional decline (n=156).  

Conclusions 

The RACE model can safely manage a substantial proportion of cancer- and treatment-related complications outside ED, including high-acuity presentations. These findings support expansion of ambulatory oncology services in reducing ED utilisation whilst maintaining timely patient-centred cancer care.